Hi all,

In my last post, I was *not* referring to the Code, as important as it is and as justified it may be to exclude certain companies form advertising in the JHL.
I was talking about the content of the ad, about the message it tries to bring across.
So... even if we would consider Lansinoh okay as advertiser, I think *this specific ad* should not get passed *our* smell test as ILCA-members.
I did this before, dissecting the text of an ad and I can do it again, if that helps to get my point across, regardless of the Code-issue; I repeat: REGARDLESS of the Code-issue.
It's my last post for today, so after this one, I'll keep my mouth shut, at least until tomorrow. ;o))

Below is the text and I give my comment in between the lines of it:

"For over 20 years, Lansinoh has provided products of superior quality and safety aimed at encouraging and increasing the incidence and duration of breastfeeding."

Comment: How will products encourage and increase the incidence and duration of breastfeeding? What mothers need, is knowledge, expertise, and most of all close (social) support.
Products increasing incidence is blatant nonsense: you don't start a certain behaviour because you know that there is a product that can solve all the problems you will encounter with that behaviour.
By the way... how succesful has this 'being aimed at' been...? Data, please, from an RCT!

"In the early postpartum days, many moms experience engorgement or swelling in their breasts, a temporary condition that can make breastfeeding difficult and one that can result in temporarily flat nipples."

Comment: Knowledgeable hcp's will know that in most cases engorgement that makes nipples so flat that they need to be drawn out, can be prevented by good bf management. We don't want to fight symptoms: we want to prevent problems that cause symptoms in the first place. And if symptomsdo arise, we start with improving management and offering solutions that cost nothing. One of that is, as mentioned by others, rps; there are others, such as gently massaging milk out, taking a shower, compresses, cabbage leaves (heard again in GOLD: sulfar/alkoid with topical effect) or even pumping, as many mothers will already have a pump or will buy one for later on. If only we could keep mom and baby s2s, not give them so many medications that they are both hindered by the effects and don't feed on the clock and make both nervous by checking blood sugars all the time (GOLD, Martin Ward-Platt).

"In our efforts to help moms address these issues and to help them get through rather than give up breastfeeding altogether, Lansinoh created the LatchAssist."

Comment: See above; the issues need to be addressed by an experienced hcp, probably preferably an lc. If this product can do the trick for us, why should we do GOLD and ILCA-congresses and certify in the first place? Why go through the hassle of selling those moms knowledge, if we want to sell anything, that makes them self-reliant and proficient? Why not sell them a product?

"Current recommendations for addressing temporarily flattened nipples are cumbersome and time-consuming - valuable time that is being taken away from one's breastfeeding baby."

Comment: Now all of a sudden the nipples are flat. Admitted: they are preceeded by the word 'temporarily', but how easy it is, to insert the word 'flat' into the mix now that we're at it. "Ma'm, you have flat nipples". "Oh, oops, the ad sad 'flattened'... oh yes, 'temporarily flattened'... well, never mind. They're flat anyway, for now, so better stick a gadget onto them. That will help." You know what is cumbersome and time-consuming? Having a baby, that takes all your valuable time away from yourself. But now that it is there and cannot be returned, we might as well spend time with it, from the very first moment. That will help to prevent the breasts from becoming engorged and will save the mom the hassles of cumbersome and costly remedies to solve that problem.

"Lansinoh LatchAssist was designed to be small, convenient, and easy-to-use so mom can use it one-handed while the baby is positioned for latch-on and nursing so the baby can alleviate the engorgement or swelling."

Comment: Right, so we *DO* get the information that *the baby* should drain the breast. Maybe we're getting onto something here... Oh, wait a minute... "Gadget in one hand, baby in the other... but I don't know how to position my baby yet, as it is my first and I'm on day three now. That's why I'm engorged, so now I'm not only supposed to put that baby to breast in the right way, but to be able to do that *with one hand*, instead of with the two I was blessed with, so that one can securely hold my baby and the other can position and form my breast in a way that makes it easier for my little one to latch... or, wait... I might lie down and do laid back breastfeeding (GOLD, Suzanne Colson) so that my baby can self-attach, but then I need both arms to build him a safe area to bob around in while he's looking for either breast, so where do I find my third hand to position the L.A.? By the way... the baby cannot drink that breast while that thing is still on, so how to arrange all that? Put it on first, wait until the nipple is drawn out and keep my baby happy in the meantime... and all this is supposed to be convenient and easy-to-sue... I must be a very clumsy mom, not being able to accomplish this..."

"AND, IT WORKS! Nine out of ten mom who use LatchAssist find it effective, easy-to-us, and comfortable and much easier to use than a manual or electric breastpump to evert their nipples."

Comment: Who did the research that came up with 'nine out of then' and where can we find these results? What was the design of the study? Who funded it? Were there any conflicts of interest? (Duh!)
How were these women, who found the L.A. easier than another method, guided and supported in their breastfeeding process? Who gave them other instructions to compare the ease of use? What other instructions were given, apart from the use of breastpumps? What did the control group do and how well did it work? Data, please, from an RCT!

"For more information, please contact us at (and so on).
We've built an online community for moms. Please encourage your moms to share their breastfeeding adventures at www.and-so-on."

Comment: Is this the kind of community we want to refer moms to? Or do we refer them to not-for-profit breastfeeding fora, that advertise slings and massage oils and healthy juices for mom and other nice stuff that doesn't interfere with feeding and responsive parenting?

I'll leave it at this. I suppose this should finally do to get my point across. Like Linda said: ethichal marketing is not limited to behaving within the boundaries of the Code.
Ellen feels everyone has to do what they believe is ethically correct. That will indeed differ from organisation to organisation. We are all here on Lactnet, I would reckon, to learn from beliefs and experiences of others and hopefully when the others make good points, we will act accordingly in our daily practice. Those good point also may lead to changing our beliefs about what is ethically correct. I sure learned a lot this last one and a half year. This is the level at which I would like to discuss issues. This is the place where discussions don't drop dead, as soon as someone comes up with a different opinion. It's tricky sometimes, to plainly state how you feel about things, even if you have a lot to back up your view. But hey... isn't that what should be at the core of our professional behaviour: thoroughly check things out, benefit from 'osmosis learning', right here, on the spot, where so much passion and expertise is gathered, and THEN be the rock of strenght that mothers need in that intensive and vulnerable first period? Don't let that be spoiled by rubbish from manufacturers, and most certainly not at the back of what is supposed to be *THE* evidence-based journal of human lactation.

Warmly,

Marianne Vanderveen IBCLC, Netherlands

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